The lay press can be quick to jump on reports in the medical literature, especially when it comes to snoring and obstructive sleep apnea. This has positive and negative impacts, but one of the downsides is that the public can read an article and misunderstand the findings. Companies with products described in medical articles can exaggerate the findings, leading many patients astray in the search for a simple, cure-all.
Chin straps (shown below) are commonly used to treat patients with obstructive sleep apnea who open their mouth during use of positive airway pressure therapy. Opening the mouth allows air to escape from the mouth when a patient is wearing a mask over their nose or with inserts that extend into the nostril (nasal pillows). However, they are not used often as treatment by themselves. An article published in 2007 in the Journal of Clinical Sleep Medicine showed that a single patient with sleep apnea experienced resolution with wearing a chin strap (shown below). Since that time, I have seen a number of patients with sleep apnea come in and report that they have tried a chin strap after being unable to tolerate positive airway pressure therapy. This is in addition to many patients with snoring (but without sleep apnea) who have tried a chin strap unsuccessfully after searching on the Internet and looking for solutions.
Do chin straps improve sleep apnea? Unfortunately not so much.
The August 2014 issue of the Journal of Clinical Sleep Medicine included an article reporting results from a study of using chin straps to treat obstructive sleep apnea. In 26 patients with obstructive sleep apnea, there was no improvement in any measure of obstructive sleep apnea or snoring. The authors evaluated different components of sleep to see if certain patients might benefit. For example, a change in the degree of sleep apnea during rapid eye movement (REM) sleep or while sleeping on one’s back (supine) might suggest that patients with sleep apnea limited to these situations would be ideal candidates for a chin strap. Unfortunately, there were no improvements in these either.
The bottom line is that chin straps do not appear to be viable treatment treatment options for most patients with sleep apnea. This study did not include patients with snoring who did not have sleep apnea. My personal experience is that patients with snoring or, to a much lesser extent, sleep apnea who are mouth breathers during sleep (especially if the snoring occurs only when mouth breathing) can do well with chin straps as part of their overall treatment plan. However, those patients are less common than we might believe by looking at online advertisements. What is missing is that many patients are mouth breathers because they cannot physically breathe through their nose. This is where a comprehensive approach is required, requiring that we open the passageways for breathing in the nose. As in all of medicine, talking to patients (and their bed partners) about their snoring and breathing patterns during sleep can identify those who have substantially worse problems when mouth breathing or especially bad blockage of breathing in the nose. These suggest a possible role for chin straps, often in combination with opening the nose with medications or a procedure.
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John Micelli says:
I use a chin strap to stop snoring, highly effective, and is true that is not helping so much against sleep apnea. Also when I go to sleep I like to drink chamomile tea to relax and sleep better.
Michael Wall says:
OMG, Why would a chinstrap alone ease symptoms of sleep apnea? I use one to discourage mouth breathing at night, but that is as a part of breathing therapy I am doing or I use one with my CPAP mask depending on which one I use, to avoid dry mouth the next morning. My particular full face mask, of course not only covers my mouth, but (I think) helps to keep it shut. At best a chin strap will just cause you to breathe through your nose, which seems unlikely to treat sleep apnea in my opinion.
Dr. Kezirian says:
Nose breathing is usually better for snoring and sleep apnea, and chin straps can help certain patients. However, that is really the exception and not something where chin straps should be a routine approach to consider for most patients.
david says:
I use a tegaderm film to cover my mouth before I go to sleep–this and the chin strap have helped my sleep apnea immensely
Kelleen says:
Could you use this film in conjunction with a full face mask with cpap machine? I am still snoring because my mouth opens at night. I fear the snore chin strap will be in the way of the cushion on the mask.
Dr. Kezirian says:
Absolutely. You would need to be careful in not interfering with the seal of your mask, however.
Kim says:
How do you use trader film over your mouth for sleep apnea? How does it work, what do you do?
Dr. Kezirian says:
I am not familiar with this and do not use various approaches to taping the mouth shut. The key really is having your jaw closed and in a position whether the teeth are touching, so it is more than just taping the lips together.
Dan says:
>These suggest a possible role for chin straps, often in combination with opening the nose with medications or a procedure.
No side effects or risk with Breathe Right strips.
Dr. Kezirian says:
There are ways to evaluate whether these would make sense for someone to consider. There are no major risks with these, other than irritation of the skin or nuisance (and some cost). The real issue is that people want to move forward with something that has a reasonable chance of working, especially when we are discussing a potentially serious medical condition like obstructive sleep apnea. We have to look at research and not just marketing materials.
ADELE F NEWSOME says:
Adele
i have severe Sleep Apnea and was prescribed a c pap machine. It is bulky and inconvenient for travel, would the chin strap be suitable for travel ?
Dr. Kezirian says:
I have responded to others with a similar question. I would not recommend wearing a chin strap as a stand-alone treatment for sleep apnea.
john says:
is using only a chin strap safe when you have sleep apnea? is it possible that you stop breathing if you wear a chin strap and breathing through you nose stops due to apnea?
Dr. Kezirian says:
I would not recommend wearing a chin strap as a stand-alone treatment for sleep apnea. What you have described is one of the many reasons. Another reason is that, even if you do not have trouble breathing through your nose, chin straps have not been shown to work in sleep apnea.
Peter says:
Hi Dr Kezirian,
I appreciate this post, and your responsiveness to these questions. It’s hard to find a website that ISN’T spruiking these ‘devices’ (that are usually no more than a piece of fabric, but costed $30-200).
I am a ‘natural’ mouth breather due to my first 18 years of life in a dust-full home (I have dust/mite allergies) – I have taught myself to breathe through my nose during the day (although at times e.g. in Spring can only breathe through 1 nostril) – but my natural position is to breathe through my mouth. At nights I mouth breathe, with dry mouth every morning; and if I drink any alcohol, I often snore (I think due to its relaxant properties?)
I read that aforementioned study ~2 years ago so decided not to try a chin strap – and I am wary of it giving me sleepless nights due to breathing difficulties – are there any studies on these for non-sleep-apnea snorers, that you know of?
Thanks in advance,
Peter.
Dr. Kezirian says:
You probably want to be treated for the allergies or other causes of nasal blockage and then try to do what you can to breathe through your nose rather than your mouth. I do not know of good studies evaluating chin straps for snoring without obstructive sleep apnea, but they might work–if your nose is open for breathing.
Barb says:
I use a full face mask with memory foam (couldn’t stand the gel) and still find it irritating. I have started wearing a chin strap also b/c my mouth gets very dry so must still be dropping my jaw. The mask itself pushes my cheeks together so the natural tendency is for my mouth to open. The fabric of the chin strap irritates my skin and makes it itchy & red. On the nights that I can get to sleep & stay there–or go quickly back–the combo works well for sleep even though my skin is still irritated in the morning. When it doesn’t work, I can lay awake for hours which is certainly counter productive so eventually I remove it all.
I would like to know if a natural fabric chin strap combined with nasal pillow will work for me. I am definitely a mouth breather–do so even during the day at times.
Dr. Kezirian says:
You would probably benefit from opening the space for breathing in your nose. As for fabrics, I am not an expert in this. I would recommend looking online or contacting a medical equipment company.
Carroll Seigars says:
I can tell you after 20 years of severe obstructive sleep apnea ( good doctors bad doctors, sleep study after sleep study) that there is no cure except possible throat surgery with a long recuperative time and with no guaranty of success. All you can do is safely manage it by trial and error. My jaw falls open as well and gives me terrible dry mouth which forces me to drink about 10 times per night and it affects your sleep cycles terribly. The C-pap or C-flex machines run out of humidified water vapor within 3 hours. All that I have tried, (at an absurd price)share that same problem of inadequate water supply. Also, one doctor told me I had central brain apnea and the other said obstructive apnea. I know that it is obstructive because I can feel and hear it catch on the exhale. Not my brain. I have found that a chin straps combined with your c-pap will work fairly well. The problem is that purchased chin straps do not have enough elastic holding power to keep my jaw from falling open. Answer: I have had to have my wife sew extra wide elastic material to make the chin strap powerful enough to hold my jaw closed. It’s not 100% perfect, but it the best solution I have found.
Charles Graham says:
I have not slept in years i am 29 and because of the lack of sleep i feel like im in my 70’s the way i nod off in front of company i feel like a drug addict… ive had countless issues with my CPAP machine and being the rebel that I am I just wouldn’t wear it so they finally got me to use the nostril pillows but my mouth kept opening I noticed so once again I just stopped wearing it but now it’s getting to the point where every night I’m waking up gasping for air I can’t sleep in the bed with my girlfriend because I feel like I’m disturbing her sleep and I’m just pretty much fed up at this point I’ve went on so many different articles online WebMD everywhere and it’s all about marketing finally I come here and I read through most of the comments and I come across this one I’ve always wondered if chin straps would work along with the nostril pillows for the CPAP machine and I’m not a rocket scientist but I figured common sense would show that if the jaw would stop opening while there’s a constant flow of air being pushed through your nostrils there would be nowhere for the air to escape end result you will have if not a perfect night sleep at least a decent night and it would be beneficial towards your sleep apnea treatment now the only issue with that is to find a chin strap that is not only strong enough to hold the jaw shut but also not too much to break your pockets hearing that you have tried this has given me some hope that maybe I can actually get some sleep again…..
Thank you.
Charles
Dr. Kezirian says:
You are welcome. Good luck!
Deborah Tapper says:
A simple test for everyone. Mouth open, easy to make the snoring sounds. Shut your mouth, impossible or very difficult to make the snoring sounds. Mouth breathing develops in children who suffer allergies that block their noses and sinuses. That was me. I am watching my 15 yr old boy closely. Asthma, allergies. My own father had all teeth removed by 28, and dentures. Big allergy sufferer, hayfever, mould, dust, cats. I would watch his subconscious jaw clenching as a child when he read the paper. Mouth breathers allow oxygen in that feeds the cavity making bacteria. Growing faces develop differently. Narrow arches, crowded back teeth. I suffered tooth decay, root canals, 3 teeth implants….all this from mouth breathing. Through my youth, 20’s, 30’s, 40’s often waking with headaches from teeth grinding. Disturbed sleep. Some say grinding teeth is a way to jolt the sleeper to breathe again….it’s all connected. Now I mouth tape AND wear a chin strap. A lifetime of clenching means my jaw sometimes still aches, like a biofeedback thing, but I sleep soundly, never stir, my anxiety has diminished, my mouth is ‘sweet’ when I remove the tape. There is a different exchange of gases happening with air intake through the nasal passages that requires less oxygen in the lungs through the long night. Mouths are for eating. Noses for breathing. None of my ‘issues’ are around excess weight. I’m a petite 5’2 EX mouth breather. Magnesium glycinate also helps me relax the jaw and to sleep.
Dr. Kezirian says:
I am so glad you are doing much better now with the mouth tape and chin strap. I believe I mentioned in the post that I think chin straps have a definite role for selected patients. In fact, I recommend them to certain patients. However, the idea that they are a cure-all for most patients with snoring or obstructive sleep apnea has been disproven pretty clearly.
Alan says:
I find the CPAP very uncomfortable and experiance a Common problem that I have read in these Comments being the irritation from the mask and dry mouth, surly the manufactures of the CPAP can come up with a better face or Nasal mask, as I have often heard it describerd ( the dreaded CPAP).
I have found that using a bed wedge combined with a chin strap has worked wonders for me, the bed wedge seems to stop the closing of the muscels in the throat by elevating my upper body at an angle and the Chin strap stops the dry mouth.
nicky melville says:
I too use a wedge pillow and put a special anti-snoring pillow on top of the wedge and it does seem to work. Imean, I haven’t been tested, but before I did this I used to wake every night gasping for air and had the most horrible nightmares that I was under water and couldn’t breathe and horrid things like that. I haven’t had that since I have used the wedge pillow etc. I tried gamely for two whole years with a CPAP machine and it drove me totally demented! I am afraid that I used to crudely call it my CRAP machine! it was SO uncomfortable and my sleep got worse and worse and I actually started to get claustraphobic even though I am normally a very placid and calm person. I think that I might try the chin strap as occasionally I find that I have turned onto my back in my back in my sleep and am not quite sure if my airway is being blocked or not. Do you think a chin strap as well might help a bit, just to make sure?
Dr. Kezirian says:
Chin straps may help if you are mouth breathing at night – but only use them if breathing through your nose is relatively open! Of course, you do want to be sure that these are helping you feel better and also conrolling your sleep apnea, so I would remain in contact with your doctor to see if you might need a sleep study using these treatments.
Norma says:
Nicky
Could you please tell me the name of the special anti-snoring pillow?
Thank you.
Dr. Kezirian says:
There is no special anti-snoring pillow. I would never buy a pillow specifically for this. If you want, you can use any pillow in a position that tilts your head back slightly.
Andy says:
Ive read all the comments and this has been extremely helpful. THANKS
Inge Bock says:
I am only new to sleep apnea , coming up 12 months. At the beginning it worked wonders for me , but now I find I wake up a lot through the night and feel tired throughout the day , not as bad as I use to be , but I know it has declined . My biggest problem is my chin strap , I find the chin strap sits in the grove under my lip but does not keep my mouth from opening . If I pull it up a bit and really tight I get headaches , and now the top of my head feels like it is bruised . I have been trying to design a better chinstrap , but have not been successful , I have an idea but am not smart enough to make it , but will keep trying ..
JOHN HALL says:
I HAVE BEEN USING CPAP FOR 25 YEARS AT PRESENT IAM HAVING TROUBLE WITH MY MOUTH DROPPING OPEN . I HAVE USED ALL DIFFERENT CHIN STRAPS THAT ARE NOT HELPING. CAN SOMEONE PLEASE OFFER A BETTER SOLUTION. JOHN H
Rick says:
I have been diagnosed with OSA and have had terrible sleeping patterns and chainsaw snoring so bad that moving to another room was not enough for my partner to get any sleep. About 3 weeks ago, I quit smoking. My partner and I were talking about the snoring and gasping during my sleep and it was pointed out that when I breathe through my nose and not my mouth, I make no noise and do not gasp for air. I started using Flonase every night before bed and the Breathe Right strips. These in addition to my no longer smoking has in effect cured my sleep apnea. I no longer wake my partner during the night, I have so much energy now and I no longer feel the need to nap during the weekends or after coming home from work. I do believe the key was to cease with the cigarettes, first and foremost.
Dr. Kezirian says:
I am so glad that you quit smoking and that it improved your breathing during the day and night so much. Congratulations! This is fantastic.
David W says:
Hello Dr. Keririan, Over the past year I’ve been dealing with waking up tired and significant fatigue though-out the day. After having many blood test done, I also completed two sleep studies. Both coming back with mild sleep apnea. However, my oxygen level did drop to 84% occasionally thought out the night. My question is, I’ve been using a cpap machine for a few weeks at a very low advised setting 4.0-6.5. Using only the nasal mask. At such a low setting would a chin strip help with a cpap machine or could I possibly use it without the machine. And, if the cpap therapy isn’t working do you have any advice on who to see to advance my issues. Thx you very much for your help.
Dr. Kezirian says:
If CPAP is not working for you, then seeing a sleep surgeon to consider alternatives can make complete sense. You are asking some specific medical questions. Answering them properly would require an evaluation and discussion of what be helpful for you. I do provide online consultations (for example, using Skype), but an in-person evaluation would be even better if that is straightforward for you. Please feel free to e-mail me directly if you are interested in an evaluation.
Dave Armstrong says:
Thank you Dr. Kezirian for all of the helpful information.
In my situation, a newly acquired MAD seems to be helping with my OSA, however I find that when sleeping in a supine position, often my jaw will relax to the point that my mouth falls open enough that the MAD loses contact with my upper teeth. Naturally, this in turn causes my now-unsupported lower jaw to recede, and the airway blockages (and sleep interruptions) to return.
I’ve seen the research that contraindicates standalone chinstrap use for treating OSA, however I’m wondering if a chinstrap might be effective for me in keeping the MAD in proper position so it can function as intended. Curious to hear your thoughts on that particular circumstance, or if you are aware of research in the area of chinstrap use with a MAD. Surely I’m not the first person to run into this.
Signed,
Desperately Hoping to Avoid CPAP
Dr. Kezirian says:
I am not aware of any research on combining a chinstrap with the MAD. I would just try it. It should not be harmful, as you can just take it off if it makes things worse.
Jim says:
I do snor, but also get blocked sinuses. So I’m scared I my suffocate using a chin strap, as I won’t be able to Breath through my nose.
Dr. Kezirian says:
This is one reason that people should not just try everything they read.
Emanuele says:
The last 4 days I’ve been using brown wide tape to keep my mouth closed, & slept well doing this. As I saw this was mentioned on a website to either do this or using masking tape. But now it’s about time to buy one of those chin straps to use during the night. But still during the day I also breathe with my mouth open. So what can I do to help me to breathe with my mouth closed, because I’d feel very embarrassed using the strap during the day?
Dr. Kezirian says:
The key with breathing through your nose instead of your mouth is that you have to be able to breathe easily through your nose. If your nose is blocked, then you should discuss it with your provider and potentially see an otolaryngologist (ear, nose, and throat physician) to see if it can be opened up to allow you to breathe comfortably.
Emanuele says:
Thank you very much for all your advice, of who I should see first. So I’ll book an appointment with my family doctor for a referral to see one as soon as possible. Or I’ll ask my Neurologist as my appointment with him mid May next month.
Emanuele says:
Thank you Dr. Meridian for your advice because I’ve taped my mouth last night. So I’ll ask my brother to book an appointment with my GP to arange a referral with an otolaryngologist in the General hospitaolin Cheltenham Gloucestershire or in the Gloucester Royal hospital in the same county Gloucestershire. For a test then see what that doctor will say to me, & if I’ll receive a chinstrap to us over night, & see what I can use during the day to breathe through my nose for the rest of my life.
SK says:
Thank you for the helpful information on this page. I wear a custom made dental device at night on my upper teeth (for grinding and jaw issues). Unfortunately wearing the device means that I can’t keep my lips together. I end up breathing through my mouth as a result. I’m wondering if you may have any tips for someone who is forced to breathe through the mouth due to a dental appliance.
Dr. Kezirian says:
There is not an easy solution for this. It may not be a major problem (other than some possible discomfort) if the appliance is taking care of your snoring and sleep apnea. If it is not working well, you should be evaluated to consider other options, whether replacing your oral appliance with another treatment or adding a treatment to use of the appliance.
Virginia Nelligan says:
.i am using an oral appliance for my OSA (mild). Not to sure if it is working because I am up so much during the night with dry mouth. I take thyroid medicine around 8:30 pm with approx. 6 – 8 ozs. Of water, which also effects my getting up during the night. Not sure if it because of dry mouth or needing the bathroom that wakes me up. Am thinking of getting a chin strap to help keep my mouth shut but am unsure what it might do while wearing the oral appliance that is pulling my lower jaw forward.
Any suggestions or advice would be appreciated.
Dr. Kezirian says:
A chin strap may be helpful, but sometimes the oral appliance makes it difficult for someone to close their lips (leading to dry mouth). To check how well the oral appliance is working, patients often will get a sleep study while wearing their appliance.
Manolina Sosa says:
Hello Dr. Kezirian, I have a severe Sleep Apnea, and using a CPAP with the pillow nose for a year with not problem at all, until for the last 4 days, I started waking up like feeling my mouth shake and air is coming through it. I called the company that provided the Sleep Machine and they said I am having a 35 % leak, and suggest to use the Chin Strap. Do you think that will help me? Last week for 2 days I had a monitor for my heart. The result said my heart rate went down to 39 a few times during the day and sometimes at night, I’m waiting to see another Heart Specialist. I am diabetic, obese and 69 years old.
Dr. Kezirian says:
This may help, but you should absolutely discuss this with your health care provider too.
Fayne Bouguyon says:
I’ve been using a chinstrap alone for about 4 years. It hasn’t stopped my snoring, but it definitely seems to have stopped my sleep apnea. I have finally been able to sleep through the night. I no long wake up startled and gasping for air. I hate wearing it, but I can’t imagine life without it.
Dr. Kezirian says:
I am so glad to hear that you have had a good response. There are occasional patients for whom this works well, but this is advertised broadly as a potential treatment without evidence to support its use for most patients.
Lisa says:
I have been snoring for around 7 years, then developed sleep apnea, and high blood pressure that increased at night. I also had to urinate all night. Recently, my nighttime pressure went to 150/100 for a week! I am a mouth breather. I taped my mouth, and my blood pressure went to 123/85. The nighttime urinating stopped. Now, I ordered a chin strap to add, but I can never stop the mouth tape. Like you said, It won’t work for everyone. If I don’t wear the tape, my pressure will rise. It’s been 117/79 most days now, but I still need to see a physician to get to the root cause of the mouth breathing.